Alashkham Abduelmenem, Alraddadi Abdulrahman, Felts Paul, Soames Roger
1 Centre for Anatomy and Human Identification, University of Dundee, Dundee, UK.
2 Human Anatomy Department, Faculty of Medicine, University of Zawia, Zawia, Libya.
J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017731632. doi: 10.1177/2309499017731632.
Tears of the glenoid labrum are common after dislocation of the glenohumeral joint. The outcome for healing or surgical reconstruction of the glenoid labrum relies on the extent of its vascularization. This study aims to evaluate the glenoid labrum blood supply and to determine its regional vascularity.
A total of 140 shoulders (30 male and 40 female cadavers) were examined: mean age 81.5 years, range 53-101 years. All blood vessels around the glenohumeral joint were dissected and recorded. Ten specimens with the glenoid labrum and fibrous capsule attached were randomly selected and detached at the glenoid neck and subjected to decalcification. Sections (10-20 μm) were cut through the whole thickness of each specimen from the centre of the glenoid fossa perpendicular to the glenoid labrum at 12 radii corresponding to a clock face superimposed on the glenoid. Sections were stained using haematoxylin and eosin and then examined.
The blood supply to the glenoid labrum is by direct branches from the second part of the axillary artery, subscapular, circumflex scapular and anterior circumflex humeral and posterior circumflex humeral arteries, as well as branches of muscular arteries supplying the surrounding muscles.
This study shows that the glenoid labrum has a rich blood supply suggesting that, regardless of the types of the glenoid labrum lesions or their management, an excellent outcome for glenoid labrum healing and joint stability is possible. The observations also suggest that the blood supply to the glenoid labrum is sufficient, enabling its reattachment.
盂肱关节脱位后,肩胛盂唇撕裂很常见。肩胛盂唇愈合或手术重建的结果取决于其血管化程度。本研究旨在评估肩胛盂唇的血液供应并确定其区域血管分布。
共检查了140个肩部(30具男性和40具女性尸体):平均年龄81.5岁,范围53 - 101岁。解剖并记录盂肱关节周围的所有血管。随机选取10个附着有肩胛盂唇和纤维囊的标本,在肩胛盂颈部切断并进行脱钙处理。从肩胛盂窝中心垂直于肩胛盂唇,以对应于叠加在肩胛盂上的钟面的12个半径方向,将每个标本全层切成10 - 20μm厚的切片。切片用苏木精和伊红染色后进行检查。
肩胛盂唇的血液供应来自腋动脉第二段的直接分支、肩胛下动脉、旋肩胛动脉、旋肱前动脉和旋肱后动脉,以及供应周围肌肉的肌动脉分支。
本研究表明,肩胛盂唇血液供应丰富,这表明无论肩胛盂唇损伤的类型或其处理方式如何,肩胛盂唇愈合和关节稳定性都可能取得良好结果。这些观察结果还表明肩胛盂唇的血液供应充足,能够实现其重新附着。